ED visits decline by nearly half during early phase of COVID-19 pandemic
Visits to the ED decreased by 42% during the early phase of the COVID-19 pandemic, from a mean of 2.1 million visits per week from March 31-April 27, 2019 to 1.2 million visits from March 29 to April 25, 2020, according to findings in the MMWR report.
“On March 13, 2020, the United States declared a national emergency to combat coronavirus disease 2019 (COVID-19),” Kathleen P. Hartnett, PhD, of the Innovation, Technology and Analytics Task Force from the CDC COVID-19 response team and the division of health informatics and surveillance at the CDC, and colleagues wrote. “As the number of persons hospitalized with COVID-19 increased, early reports from Austria, Hong Kong, Italy and California suggested sharp drops in the numbers of persons seeking emergency medical care for other reasons.”
To assess trends in ED visits during the pandemic, the CDC analyzed data from the National Syndromic Surveillance Program, as well as academic and private sector health partners, to obtain electronic health data from hospitals in 47 states, excluding Hawaii, South Dakota and Wyoming), which would capture nearly 75% of ED visits in the U.S. Total ED visit volume, patient age, sex, region and reason for visit were examined.
Overall, ED visits decreased 42% during the early COVID-19 pandemic, from an average of 2.1 million per week from March 31 through April 27, 2019 to 1.2 million from March 29 through April 25, 2020. The steepest decreases occurred among people aged 14 years and younger, with visits by children aged 10 years and younger decreasing by 72% and visits by children aged 11–-14 years decreasing by 71%, women (45%) and individuals from the Northeast (49%).
During the early pandemic period, the proportion of ED visits for exposure, encounters, screening or contact with infectious disease compared with total visits was nearly four times as large as that during the comparison period a year earlier (prevalence ratio [PR] = 3.79; 95% CI, 3.76-3.83). Other diagnostic categories with the greatest number of visits during the early pandemic included other specified and unspecified lower respiratory disease, which did not include influenza, pneumonia, asthma or bronchitis (PR = 1.99; 95% CI, 1.96-2.02), cardiac arrest and ventricular fibrillation (PR = 1.98; 95% CI, 1.93-2.03) and pneumonia not caused by tuberculosis (PR = 1.91; 95% CI, 1.90-1.93).
“The striking decline in ED visits nationwide, with the highest declines in regions where the pandemic was most severe in April 2020, suggests that the pandemic has altered the use of the ED by the public,” the authors wrote. “Persons who use the ED as a safety net because they lack access to primary care and telemedicine might be disproportionately affected if they avoid seeking care because of concerns about the infection risk in the ED."